Surgical Instrument with Articulating Assembly

ABSTRACT

A surgical instrument includes a housing having an elongated member assembly extending from the housing. The elongated member has a first portion and a second portion. The second portion is movably coupled to the first portion by a cable that facilitates the relative movement of the first portion and the second portion.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 61/584,702, filed Jan. 9, 2012, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND

1. Technical Field

The present disclosure relates generally to surgical instruments for useduring a minimally invasive surgical procedure. More particularly, thepresent disclosure relates to surgical instruments having articulatingassemblies for use with surgical access devices.

2. Description of Related Art

Increasingly, many surgical procedures are performed through smallincisions in the skin. As compared to the larger incisions typicallyrequired in traditional procedures, smaller incisions result in lesstrauma to the patient. By reducing the trauma to the patient, the timerequired for recovery is also reduced. Generally, the surgicalprocedures that are performed through small incisions in the skin arereferred to as endoscopic. If the procedure is performed on thepatient's abdomen, the procedure is referred to as laparoscopic.Throughout the present disclosure, the term minimally invasive is to beunderstood as encompassing both endoscopic and laparoscopic procedures.

During a typical minimally invasive procedure, surgical objects, such assurgical access devices (e.g., trocar and cannula assemblies) orendoscopes, are inserted into the patient's body through the incision intissue. In general, prior to the introduction of the surgical objectinto the patient's body, insufflation gas is used to enlarge the areasurrounding the target surgical site to create a larger, more accessiblework area. Accordingly, the maintenance of a substantially fluid-tightseal is desirable to inhibit the escape of the insufflation gas and thedeflation or collapse of an enlarged surgical site. In response to this,various access devices with sealing features are used during the courseof minimally invasive procedures to provide an access for surgicalobjects to enter the patient's body. Some of these devices areconfigured for use through a single incision or a naturally occurringorifice (i.e. mouth, anus, or vagina) while allowing multipleinstruments to be inserted through the device to access the workingspace beyond the device.

During procedures employing surgical instruments through a singleincision access device, it is advantageous to move the positioning ofthe end effector of the surgical instrument.

One example, as disclosed by U.S. Pat. No. 5,520,678, uses control ballsdisposed in a proximal and distal end of a device, such that rotationand pivoting of the proximal control ball is transmitted to the distalcontrol ball and consequently articulates an end effector at the distalend of the device.

Another example, as disclosed by U.S. Pat. No. 5,511,564, is a surgicaldevice having a frame member with a pair of tissue holding mechanisms.An actuator mechanism allows positioning of the tissue holdingmechanisms such that a portion of tissue can be stretched, providing adesirable surgical site.

However, a continuing need exists for improved articulating surgicalinstruments for use through single incision access devices.

SUMMARY

The present disclosure relates to a surgical instrument including ahousing having an elongated member assembly extending from the housing.The elongated member assembly has a first portion and a second portion.The first portion is proximal the second portion. In addition, a supportmember is secured to the housing. The first portion is movablypositioned about the support member to articulate the second portionrelative to a longitudinal axis extending through the elongated memberassembly. The first portion may define a first loop cable channel aboutan outer surface of the first portion.

The second portion is movably coupled to the first portion by a cablethat facilitates the relative movement of the first portion and thesecond portion. A pivot pin is secured to the second portion and thesupport member. The second portion articulates about a pivot axisdefined through the pivot pin relative to the first portion in responseto rotation of the first portion about the longitudinal axis. The pivotaxis is transverse to the longitudinal axis. The pivot pin is fixedlysecured to the second portion such that force transferred through thecable upon movement of the first portion rotates the pivot pin andarticulates the second portion relative to the first portion. The pivotpin may extend beyond an outer surface of the second portion to form acontacting surface. The pivot pin may define a second loop cablechannel.

The cable defines a first loop and a second loop. The cable may be asingle cable which crosses itself at a single point to form the firstand second loops. The first loop is secured to the first portion and thesecond loop secured to the second portion. The first loop is fixed at afirst fixed point on the first portion and the second loop is fixed at asecond fixed point on the pivot pin. The first loop of the cable is atleast partially disposed around an outer surface of the first portionand the second loop is at least partially disposed around an outersurface of the pivot pin. The first loop of the cable may be at leastpartially disposed within the first loop cable channel. The second loopof the cable may be at least partially disposed within the second loopcable channel. The second loop may be at least partially in contact withthe contacting surface.

Rotational movement of the first portion tensions one or both of thefirst loop about the outer surface of the first portion and the secondloop about the pivot pin. The tension is sufficient to articulate thesecond portion relative to the first portion about the pivot axis.

According to one aspect, the present disclosure relates to a surgicalinstrument including a cable having an intermediate section and firstand second ends. The intermediate section is secured to one of the firstand second portions. The first and second ends are secured to the otherof the first and second portion. At least a portion of the cable definedbetween the ends of the cable and the intermediate section of the cableis movable relative to one or both of the first and second portions.Each of the ends of the cable and the intermediate section of the cableremains fixed to one or both of the first and second portions. Thesecond portion articulates in relation to a longitudinal axis definedthrough the elongated member assembly and relative to the first portionupon rotational movement of the first portion about the longitudinalaxis.

In embodiments, a coupling member is secured to the first portion. Thecoupling member defines a pair of lumens. Different portions of thecable extend through each respective lumen.

BRIEF DESCRIPTION OF DRAWINGS

Various embodiments of the presently disclosed device are disclosedherein with reference to the drawings, wherein:

FIG. 1 is a perspective view of a surgical assembly including a surgicalinstrument and an access device in accordance with the presentdisclosure;

FIG. 2A is side view of a portion of one embodiment of an elongatedmember assembly of the surgical instrument of FIG. 1;

FIG. 2B is a perspective view of one embodiment of a cable of theembodiment of the presently disclosed elongated member assembly shown inFIG. 1;

FIG. 2C is an enlarged perspective view of a portion of one embodimentof a support member of the embodiment of the presently disclosedelongated member assembly shown in FIG. 1;

FIG. 3A is a front, cross-sectional view of a portion of the embodimentof the presently disclosed elongated member assembly shown in FIG. 2A;

FIG. 3B is an enlarged, partial cross-sectional view of the indicatedarea of detail shown in FIG. 3A;

FIG. 4 is a side view of a portion of the embodiment of the presentlydisclosed elongated member assembly shown in FIG. 1 in a firstarticulated position;

FIG. 5 is a side view of a portion of the embodiment of the presentlydisclosed elongated member assembly shown in FIG. 1 in a secondarticulated position;

FIG. 6A is a front view of a portion of another embodiment of thepresently disclosed elongated member assembly in accordance with thepresent disclosure;

FIG. 6B is a side view of a portion of the embodiment of the presentlydisclosed elongated member assembly shown in FIG. 6A; and

FIG. 6C is an enlarged perspective view of a portion of one embodimentof a first portion of the embodiment of the presently disclosedelongated member assembly shown in FIGS. 6A and 6B.

DETAILED DESCRIPTION OF EMBODIMENTS

Detailed embodiments of the present disclosure are disclosed herein;however, the disclosed embodiments are merely examples of thedisclosure, which may be embodied in various forms. Therefore, specificstructural and functional details disclosed herein are not to beinterpreted as limiting, but merely as a basis for the claims and as arepresentative basis for teaching one skilled in the art to variouslyemploy the present disclosure in virtually any appropriately detailedstructure.

As shown in the drawings and as described throughout the followingdescription, and as is traditional when referring to relativepositioning on an object, the term “proximal” refers to the end of thedevice that is closer to the user and the term “distal” refers to theend of the device that is farther from the user. In the followingdescription, well-known functions or constructions are not described indetail to avoid obscuring the present disclosure in unnecessary detail.

Referring initially to FIG. 1, a surgical assembly 10 includes an accessdevice 50 and a surgical instrument 100. The access device 50 isconfigured for the sealed reception and passage of the surgicalinstrument 100 when the surgical access device 50 is positioned intissue “T.” The surgical instrument 100 includes a housing 110. Thehousing 110 has a knob 112 and an elongated member assembly 120extending from the housing 110. The elongated member assembly 120 has afirst portion 122, a second portion 124, and a support member 126. Apivot pin 130 mounted to the support member 126 and the second portion124 couples the first portion 122 to the second portion 124. The firstportion 122 is proximal of the second portion 124. The elongated memberassembly 120 may include an end effector 128 supported on a distal endof the second portion 124.

As shown in FIGS. 2C and 3A, the support member 126 includes a proximalsection 126 a and a distal section 126 b. Proximal section 126 a of isfixedly secured to the housing 110. The support member 126 may besecured to the housing 110 by any suitable mechanical or chemicalfastening means known in the art (e.g., fasteners, adhesive, hook andloop, etc.) and may be integrally formed with the housing 110. Thedistal portion 126 b of the support member 126 is secured to the secondportion 124 via the pivot pin 130. In particular, the distal portion 126b includes a pair of extensions 128 defining an aperture 128 atherethrough for the reception of the pivot pin 130.

As best illustrated in FIG. 3B, the pivot pin 130 includes a wheel 132and a pin shaft 134. The pin shaft 134 extends through both the supportmember 126, namely the apertures 128 a of the extensions 128, andapertures 124 b defined in a proximal end of the second portion 124. Thepin shaft 134 is fixedly secured to the second portion 124 at opposingends of the pin shaft 134.

With reference to FIGS. 2A and 3A, the second portion 124 is movablycoupled to the first portion 122 by a cable 140 that facilitates therelative movement of the first portion 122 and the second portion 124.The second portion 124 can be articulated through angle β (FIG. 2A)about a pivot axis “A-A” defined through the pivot pin 130. The secondportion 124 articulates relative to the first portion 122 and thesupport member 126 in response to rotation of the first portion 122through angle α (FIG. 2A). In particular, the first portion 122 rotatesabout a longitudinal axis “L-L” defined through the first and secondportions 122, 124 and about support member 126. The pivot axis “A-A” istransverse to the longitudinal axis “L-L.”

Briefly referring to FIGS. 2B, 4, and 5, the pivot pin 130 is fixedlysecured to the second portion 124 such that force “F” (FIG. 2B)transferred through the cable 140 upon movement of the first portion 122rotates the pivot pin 130 via the wheel 132 and articulates the secondportion 124 relative to the first portion 122. As best shown in FIGS. 3Aand 3B, the wheel 132 extends beyond an outer surface 124 a of thesecond portion 124. The wheel 132 includes a contacting surface 132 bthat engages the cable 140. The contacting surface 132 b extends alongan outer surface 132 a of the wheel 132.

As depicted in FIG. 2B, the cable 140 defines a first loop 142 and asecond loop 144. The cable 140 may be a single cable or multiple cableswhich form a unified structure. The cable 140 crosses itself at a singlepoint 146 to form the first and second loops 142, 144. Referring againto FIGS. 2A, 3A, and 3B, the first loop 142 is secured to the firstportion 122. The second loop 144 is indirectly secured to the secondportion 124 via the wheel 132 of the pivot pin 130. The first loop 142is at least partially disposed around an outer surface 122 a of thefirst portion 122 and the second loop 144 is at least partially disposedaround the outer surface 132 a of the wheel 132 of the pivot pin 130along the contacting surface 132 b. The first loop 142 is fixed, e.g.,pinched, at a first fixed point 142 a on the first portion 122 and thesecond loop 144 is fixed, e.g., pinched, at a second fixed point 144 aon the wheel 132 of the pivot pin 130. The first portion 122 may definea first loop cable channel 122 b about an outer surface 122 a of thefirst portion 122. As best depicted in FIG. 2A, the first loop 142 ofthe cable 140 may be at least partially disposed within the first loopcable channel 122 b. FIGS. 3A and 3B illustrate that the second loop 144may be at least partially in contact with the contacting surface 132 bof the wheel 132 of the pivot pin 130. With brief reference again toFIG. 3B, the wheel 132 defines a second loop cable channel 132 c betweena pair of annular members 132 d extending from the wheel 132. The secondloop 142 of the cable 140 may be at least partially disposed within thesecond loop cable channel 132 c.

In use, and as seen in FIGS. 4 and 5, rotational movement of the firstportion 122 tensions one or both of the first loop 142 and the secondloop 144. The first loop 142 tensions about the outer surface 122 a ofthe first portion 122 and the second loop 144 tensions about the wheel132 of the pivot pin 130. The cumulative applied tension in the cable140, including tension in the first and/or second loops 142, 144 issufficient to articulate the second portion 124 relative to the firstportion 122 about the pivot axis “A-A” (FIG. 3A) and across longitudinalaxis “L-L.”

Turning now to FIGS. 6A-6B, another embodiment of an elongated memberassembly, generally referred to as 220, is similar to elongated memberassembly 120 and is described herein only to the extent necessary todescribe the differences in construction and operation thereof. Theelongated member assembly 220 has a first portion 222, a second portion224, a support member 226, one or more pivot pins 230, a cable 240, anda coupling member 250.

As best illustrated in FIG. 6B, the second portion 224 articulatesthrough an angle B in relation to a longitudinal axis “L” definedthrough the elongated member assembly 220 upon rotational movement ofthe first portion 222 via knob 112 (FIG. 1) about the longitudinal axis“L” and about the support member 226. The support member 226 remainsfixed to the housing 110 in a stationary position. In this regard, thesecond portion 224 articulates relative to the first portion 222 and thesupport member 226.

With reference to FIG. 6A, pivot pins 230 a and 230 b are secured to thefirst portion 222, the second portion 224, and the support member 226 tofacilitate the relative movement of second portion 224 relative to thefirst portion 222 and the support member 226. In this regard, the pivotpins 230 a, 230 b pivot relative to support member 226 and first portion222 while remaining fixed to second portion 224 to articulate secondportion 224 when the pivot pins 230 a, 230 b are pivoting. To pivot thepivot pins 230 a, 230 b, the second portion 224 is movably coupled tothe first portion 222 by the cable 240. The cable 240 facilitates therelative movement of the first portion 222 and the second portion 224.More specifically, first portion 222 is secured to cable 240 (describedin greater detail below) and is rotatable about support member 226 toapply force to cable 240.

With brief reference to FIG. 6C, to rotate first portion 222 about pivotpins 230 a, 230 b, first portion 222 defines a pair of elongate channels222 a, 222 b. The elongate channels 222 a, 222 b accommodate the pivotpins 230 a, 230 b in a manner sufficient to enable the pivot pins 230 a,230 b to pivot while the enabling the first portion 222 to rotate aboutthe longitudinal axis “L.” Upon rotation of the first portion 222, theforce applied to the cable 240 enables the second portion 224 toarticulate while the pivot pins 230 a, 230 b pivot.

The cable 240 includes an intermediate section 242 a and first andsecond ends 242 b, 242 c. The intermediate section 242 a may be securedto either one of the first and second portions 222, 224. The first andsecond ends 242 b, 242 c may be secured to the other of the first andsecond portion 222, 224. For illustrative purposes, FIGS. 6A and 6B showthe intermediate section 242 a fixed to the first portion 222 and thefirst and second ends 242 b, 242 c fixed on opposed sides of the secondportion 224. However, as can be appreciated, the intermediate section242 a can be fixed to the second portion 224 and the first and secondends 242 b, 242 c can be fixed on opposed sides of the first portion222. At least a portion of the cable 240 defined between one or both ofthe first and second ends 242 b, 242 c of the cable 240 and theintermediate section 242 a of the cable 240 is movable (e.g., portions244 a, 244 b) relative to one or both of the first and second portions222, 224. At the same time, each of the ends 242 b, 242 c of the cable240 and the intermediate section 242 a of the cable 240 remains fixed toone or both of the first and second portions 222, 224.

With continued reference to FIG. 6B, the coupling member 250 is securedto the first portion 222 and may be integrally formed with the firstportion 222. The coupling member 250 defines a pair of lumens 252, 254.Different portions of the cable 240 extend through each respective lumen252, 254. In embodiments, the coupling member 250 may include elongatechannels similar or identical to elongated channels 222 a, 222 b toaccommodate the pivot pins 230 a, 230 b in a manner sufficient to enablethe pivot pins 230 a, 230 b to pivot while the enabling the couplingmember 250 to rotate about the longitudinal axis “L” with the firstportion 222.

It will be understood that various modifications may be made to theembodiments of the presently disclosed device. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of embodiments. Those skilled in the art will envisionother modifications within the scope and spirit of the presentdisclosure.

1-19. (canceled)
 20. A surgical instrument, comprising: an elongatedmember having a first portion and a second portion; and a cable movablycoupled to the first and second portions to facilitate relative movementbetween the first and second portions, the cable being unitary andcrossing itself to define first and second loops, the first loopassociated with the first portion and the second loop associated withthe second portion.
 21. The surgical instrument according to claim 20,further including a housing, the first portion extending distally fromthe housing, the second portion extending distally from the firstportion.
 22. The surgical instrument according to claim 21, furtherincluding a support member secured to the housing, the first portionmovably positioned about the support member to articulate the secondportion relative to the first portion.
 23. The surgical instrumentaccording to claim 22, further including a pivot pin secured to thesecond portion and the support member.
 24. The surgical instrumentaccording to claim 23, wherein the elongated member defines alongitudinal axis that extends distally therethrough, the first portionrotatable about the longitudinal axis to articulate the second portionrelative to the longitudinal axis.
 25. The surgical instrument accordingto claim 24, wherein the pivot pin defines a pivot axis therethrough,the pivot axis disposed transverse to the longitudinal axis, the secondportion of the elongated member movable about the pivot axis as thesecond portion articulates relative to the first portion.
 26. Thesurgical instrument according to claim 23, wherein the first loop is atleast partially disposed around an outer surface of the first portionand the second loop is at least partially disposed around an outersurface of the pivot pin.
 27. The surgical instrument according to claim26, wherein rotational movement of the first portion tensions at leastone of the first loop about the outer surface of the first portion andthe second loop about the pivot pin, the tension being sufficient toarticulate the second portion relative to the first portion.
 28. Thesurgical instrument according to claim 23, wherein the first loop isfixed at a first fixed point on the first portion and the second loop isfixed at a second fixed point on the pivot pin.
 29. A surgicalinstrument, comprising: an elongated member having a first portion and asecond portion, at least one of the first and second portions definingat least one loop cable channel in an outer surface thereof; and a cabledefining a pair of loops, at least one loop of the pair of loops beingat least partially secured within the at least one loop cable channel,the cable being movable to facilitate relative movement between thefirst and second portions.
 30. The surgical instrument according toclaim 29, further including a housing, the first portion extendingdistally from the housing, the second portion extending distally fromthe first portion.
 31. The surgical instrument according to claim 30,further including a support member secured to the housing, the firstportion movably positioned about the support member to articulate thesecond portion relative to the first portion.
 32. The surgicalinstrument according to claim 31, further including a pivot pin securedto the second portion and the support member.
 33. The surgicalinstrument according to claim 32, wherein the elongated member defines alongitudinal axis that extends distally therethrough, the first portionrotatable about the longitudinal axis to articulate the second portionrelative to the longitudinal axis.
 34. The surgical instrument accordingto claim 33, wherein the pivot pin defines a pivot axis therethrough,the pivot axis disposed transverse to the longitudinal axis, the secondportion of the elongated member movable about the pivot axis as thesecond portion articulates relative to the first portion.
 35. Thesurgical instrument according to claim 32, wherein the first loop is atleast partially disposed around an outer surface of the first portionand the second loop is at least partially disposed around an outersurface of the pivot pin.
 36. The surgical instrument according to claim35, wherein rotational movement of the first portion tensions at leastone of the first loop about the outer surface of the first portion andthe second loop about the pivot pin, the tension being sufficient toarticulate the second portion relative to the first portion.
 37. Thesurgical instrument according to claim 32, wherein the first loop isfixed at a first fixed point on the first portion and the second loop isfixed at a second fixed point on the pivot pin.
 38. A surgicalinstrument, comprising: an elongated member defining a longitudinal axisand having a first portion and a second portion; a cable including firstand second ends and an intermediate section, the intermediate sectionbeing secured to one of the first and second portions, the first andsecond ends being secured to the other of the first and second portions,the cable being movable to articulate the second portion relative to thefirst portion as the first portion rotates about the longitudinal axis.39. The surgical instrument according to claim 38, further including ahousing, the first portion extending distally from the housing, thesecond portion extending distally from the first portion.